Provider Demographics
NPI:1487318168
Name:LADYGA, CHRISTINE JUNE (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JUNE
Last Name:LADYGA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BINDLOSS RD
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-1820
Mailing Address - Country:US
Mailing Address - Phone:860-639-1958
Mailing Address - Fax:
Practice Address - Street 1:627 NORWICH SALEM TPKE UNIT 2
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CT
Practice Address - Zip Code:06370-1066
Practice Address - Country:US
Practice Address - Phone:860-222-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist